Curation vs Interpretation

In relation to the molecular lab, it is important to align on the meaning of certain words. For example, people use the word annotation to mean several different things. The same with integration, validation/verification. Another example of words that are commonly used in a potentially ambiguous manner is curation and interpretation. 

Curation is defined as the process of gathering information relevant to a particular topic or area of interest. Interpretation is defined as the action of explaining the meaning of something.

Curation of somatic mutations/clinical biomarkers detected by NGS (or other multiplex testing) involves extracting information from high quality scientific literature and organizing this information in a manner such that it can be used and re-used appropriately over time by professionals in this area and updated when new information is made available (FDA, Professional Guidelines, PubMed). This is a difficult task and requires domain-specific expertise on part of the curator. The curated content is expected to be “neutral” or “unbiased”, as it simply reflects the meaning as intended in the original literature/source. The content, in essence, is a description of a cause-effect, or an association between a biomarker and its effect on treatment, prognosis or role in diagnosis based on prior observations and established premises. Ideally, the curated database is a “living”, focal source, of all validated and evidence-based facts gathered from authoritative bodies and scientific texts that support the biomarker-clinical role association. Such content does not represent a specific patient scenario, and furthermore, may not represent all real-time scenarios that could be encountered in clinical practice, even if case-report observations are included in the curated content.

Interpretation of clinical NGS biomarkers is an integral part of the patient report. It is generated from the analysis of the test results for individual patients on a case by case basis. This is similar to a clinician making a diagnosis after a careful evaluation of all results including biopsy report, facts from curated databases/knowledge source, and his/her background knowledge, the end-result of which will vary from patient to patient. As such, there is no focal source of a result interpretation that the practitioner can re-use for every patient.

To summarize, curation is an activity that is patient agnostic, and curated content represents a collective knowledge of empirically observed associations that will assist in guiding the clinical decision-making process. Interpretation, on the other hand, is a patient centric explanation of test results composed of curated knowledge, other clinical evaluation of the patient’s condition and the interpreters’ expertise that will directly translate to clinical management.

It is important to note that software enables and supports both processes in many ways. However, it could never replace the experience and opinion of the credentialed person that does the interpretation.